title: Brain hemorrhages in cerebral amyloid angiopathy.
abstract: Cerebral amyloid angiopathy (CAA) is cerebrovascular amyloid deposition. It is classified into several types according to the cerebrovascular amyloid proteins involved. Sporadic amyloid β-protein (Aβ)-type CAA is commonly found in elderly individuals and patients with Alzheimer disease. CAA-related disorders include hemorrhagic and ischemic stroke and dementia. CAA-related hemorrhages include intracerebral lobar macrohemorrhages, cortical microhemorrhages, and focal subarachnoidal hemorrhages/superficial siderosis. CAA-associated vasculopathies, such as microaneurysmal formation with fibrinoid necrosis, underlie such cerebrovascular events. Sensitive magnetic resonance imaging procedures, such as gradient-echo T2* imaging and susceptibility-weighted images, are useful to detect microhemorrhagic lesions. Amyloid images with amyloid-binding positron emission tomography ligands can detect CAA, although they cannot discriminate vascular from parenchymal amyloid deposits. Hemorrhage-inducing factors for sporadic Aβ-type CAA include apolipoprotein E genotype, thrombolytic, anticoagulation, and antiplatelet therapies, hypertension, minor head trauma, and antiamyloid therapies. We need future strategies for protection of vessel walls against amyloid-related vascular damage, such as toxicity of Aβ oligomers, Aβ-induced oxidative stress, and inflammation, as well as development of antiamyloid therapies for CAA.
authors.affiliation: Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Yamada
mesh_terms: D016229:Amyloid beta-Peptides / Q000235:genetics; D001057:Apolipoproteins E / Q000235:genetics; D016657:Cerebral Amyloid Angiopathy / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009154:Mutation; D049268:Positron-Emission Tomography / Q000379:methods*; D012307:Risk Factors
chemical_list: D016229:Amyloid beta-Peptides; D001057:Apolipoproteins E